ART score and hepatocellular carcinoma: An appraisal of its applicability

Assessment for retreatment with TACE (ART) score evaluates whether hepatocellular carcinoma (HCC) patients can benefit from transcatheter arterial chemoembolization (TACE) retreatments. As previously reported, TACE has a good prognostic effect on patients with ART score of 0-1.5, while patients with ART score≥2.5 might have minor or even no prognostic benefits. Our study verified whether ART score can guide multiple TACE retreatments in Chinese patients presenting with HCC.

Nine hundred and thirty-four patients presenting with HCC and treated with TACE were recruited from January 2008 to June 2012, at which point 137 patients had been treated with TACE at least twice and could be assessed by ART score. Patients were assessed by ART score before the second, third, and fourth TACE treatment, and divided into 0-1.5 group and ≥2.5 group. Overall survival (OS) of both groups was compared, and patients were further evaluated on whether TACE retreatment was beneficial.

Before the second, third, fourth TACE treatment, the median OS (95% CI) was respectively 25.0 (21.1-28.0) months, 29.0 (22.0-36.0) months and 24.3 (8.2-40.4) months for patients with ART score 0-1.5. 18.0 (14.5-21.5) months, 14.0 (6.4-21.6) months and 22.0 (11.8-32.3) months for patients with ART score ≥2.5. (P values were 0.036, 0.011 and 0.152 respectively).

Our results are consistent with previous study that before TACE treatment, patients should be assessed by ART score, and those with ART score 0-1.5 had superior prognosis as compared those with an ART score ≥2.5.